Vision Impairment and Ocular Morbidity in a Refugee Population in Malawi

Kaphle, Dinesh; Gyawali, Rajendra; Kandel, Himal; Reading, Angela; Msosa, Joseph

doi:10.1097/opx.0000000000000775

Cited by 14 publications

(9 citation statements)

References 19 publications

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“…Holden and colleagues (Holden et al, 2008) identified two different presbyopia definitions in epidemiological studies of presbyopia: 1) functional presbyopia, defined as needing a significant optical correction added to the presenting distance refractive correction to achieve a near visual acuity absolute (such as N8 or J1) or relative (such as 1 line of acuity M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT improvement) criteria; or 2) objective presbyopia, where the significant optical correction is defined (such as ≥1.00 D) and added to the best optical distance correction to achieve a defined near visual acuity. In more recent epidemiological studies, however, presbyopia is typically defined as a person aged greater or equal to 35 years who is unable to read binocularly N8 (or 6/12) at 40 cm or their habitual working distance, and additionally in some studies limited to those whose near vision improves with additional lenses (Cheng et al, 2016;Girum et al, 2017;Kaphle et al, 2016;Muhit et al, 2018;Nsubuga et al, 2016).…”

Section: 1mentioning

confidence: 99%

“…As highlighted previously, presbyopia has been estimated to affect 1.37 billion people worldwide by the year 2020 (Holden et al 2008). While the impact of presbyopia can be minimised relatively easily by use of a visual correction, such as spectacles, contact lenses or refractive surgery (see section 5), these corrections have a financial burden (Naidoo et al, 2016) and it is estimated that globally over 50% of adults >50 years (up to over 50% of developing world where there is a lack of awareness and accessibility to affordable treatment options (Cheng et al, 2016;Girum et al, 2017;Hookway et al, 2016;Muhit et al, 2018;Schellini et al, 2016) and up to 34% even in developed countries) do not have adequate near correction, impacting task performance and productivity (Frick et al, 2015;Holden et al, 2008;Kaphle et al, 2016;Man et al, 2016;Nsubuga et al, 2016;Zebardast et al, 2017). Even in developed countries, increasing digital demands are associated with asthenopia, perhaps due to latent accommodative dysfunction, in people in their thirties, which is a form of largely undiagnosed early onset presbyopia (Reindel et al, 2018).…”

Section: Presbyopia Social and Economic Impactmentioning

confidence: 99%

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Presbyopia: Effectiveness of correction strategies

Wolffsohn

Davies

2019

Progress in Retinal and Eye Research

232

178

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Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations, due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states "presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements". Strategies for correcting presbyopia include separate optical devices located in front of the visual system (reading glasses) or a change in the direction of gaze to view through optical zones of different optical powers (bifocal, trifocal or progressive addition spectacle lenses), monovision (with contact lenses, intraocular lenses, laser refractive surgery and corneal collagen shrinkage), simultaneous images (with contact lenses, intraocular lenses and corneal inlays), pinhole depth of focus expansion (with intraocular lenses, corneal inlays and pharmaceuticals), crystalline lens softening (with lasers or pharmaceuticals) or restored dynamics (with 'accommodating' intraocular lenses, scleral expansion techniques and ciliary muscle electrostimulation); these strategies may be applied differently to the two eyes to optimise the range of clear focus for an individual's task requirements and minimise adverse visual effects. However, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is given on presbyopic correction evaluation techniques.

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Section: 1mentioning

confidence: 99%

Section: Presbyopia Social and Economic Impactmentioning

confidence: 99%

Presbyopia: Effectiveness of correction strategies

Wolffsohn

Davies

2019

Progress in Retinal and Eye Research

232

178

View full text Add to dashboard Cite

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“…myopia generally reported in economically deprived settings [20] and may also indicate a higher prevalence of other, nonrefractive ocular conditions such as infections [21,22], which have been documented in the Rohingya camps. The existing literature on visual health among displaced populations, including a recent review [11], has documented high prevalence of blindness [12,[22][23][24][25] in these communities, ranging from 1.3% to 26.2% [11]. However, few published studies [26][27][28][29] have focused on the delivery of eye care services rather than simply assessing the existing burden, and none of these have measured the demand for comprehensive eye care service in a defined refugee community, beyond a single disease focus such as refractive error [27][28] or trachoma [29].…”

Section: Plos Medicinementioning

confidence: 99%

“…However, these initiatives have largely focused on the needs of settled populations. A growing body of information exists about the visual health and unique eye care needs of displaced people [11,12], and there is increasing awareness of the unmet need for vision care in these populations.…”

Section: Introductionmentioning

confidence: 99%

Burden of eye disease and demand for care in the Bangladesh Rohingya displaced population and host community: A cohort study

Ahmed¹,

Whitestone²,

Patnaik

et al. 2020

PLoS Med

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Background There is a growing awareness that addressing chronic as well as acute health conditions may contribute importantly to the well-being of displaced populations, but eye care service has generally not been prioritized in crisis situations. We describe a replicable model of eye care provision as delivered by Orbis International and local partners to the Rohingya and host population in Cox's Bazar, Bangladesh, and characterize the burden of vision impairment and demand for sight-restoring services in this setting. Methods and findings Orbis International and local secondary facility Cox's Bazar Baitush Sharaf Hospital (CBBSH) provide eye care support to the Rohingya population and the host community of all ages in Cox's Bazar, Bangladesh, with fixed vision screening locations established in Camps 4 and 11 of the Kutupalong refugee settlement. Structured outreach targets these camps and four surrounding local subdistricts, with referrals made as needed for refraction (glasses measurement) and cataract surgery to CBBSH. Between February 2018 and March 2019, 48,105 displaced Rohingya (70.3%, among whom 71.6% were children and 46.5% women) and 20,357 local residents (29.7%, 88.5% children, 54.4% women) underwent vision screening. Displaced Rohingya sought services from a total of 12 surrounding camps, within which coverage was 17.3%, including 43.3% (27,027/62,424) of children aged 5-11 years and 60.0% (5,315/8,857) of adults � 60 years old. The prevalence of blindness (presenting acuity < 3/60) among Rohingya patients exceeded that among local residents by 3-to 6-fold in each 10-year age group between 18 and 59 years (P < 0.001 comparing vision between the two groups in this age range), and the prevalence of cataract requiring surgery was also higher in Rohingya patients (18-29 years: 4.67% versus 1.80%,

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“…14 Further, a 2016 Malawian study also reported similar causes of vision impairment in their cohort of refugees and emphasised the importance of comprehensive eye-care services, particularly optometric, for refugees in settlement camps. 15 Studies on refugee eye health are also important because they can influence both the strategic planning and local delivery of eye-care practice which can then translate into better service provision and resource utilisation. For example, successful training of refugee health workers in basic optics have led to efficient screening services for uncorrected refractive error and the on-site provision of glasses across refugee camps located in the Thailand-Burma border.…”

mentioning

confidence: 99%

Vision impairment and refractive errors in refugees presenting to community optometry clinics in Victoria, Australia

Selvarajah

Dunt

Marella

et al. 2020

Clinical and Experimental Optometry

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Background There is a paucity of data relating to refugee eye health in Australia. This study aimed at investigating the spectrum of vision impairment and other ocular conditions in refugees utilising the Victorian Eyecare Service operated by the Australian College of Optometry. Methods A cross‐sectional study of electronic clinical records of 518 individuals (adults and children) recognised as refugees by the Australian College of Optometry and treated between January 2013 and May 2014 were identified. Extracted data included presenting visual acuities, best‐corrected visual acuities, and final refraction values (using spherical equivalents), for both eyes. Diagnoses of presenting ocular conditions were also extracted. Results Of all refugees examined, 129 (27.2 per cent) had some degree of vision impairment (≤ 6/9.5) based on presenting visual acuities in their better eye; five (1.0 per cent) being of a severe (≤ 6/60) or profound (≤ 6/120) nature. In contrast, 27 (6.3 per cent) refugees had some degree of vision impairment based on best‐corrected visual acuities in their better eye; two (0.4 per cent) being of a severe or profound nature. The prevalence of myopia (≥ −0.50 D) in the better eye was 23.0 per cent (n = 114); 25 (5.0 per cent) being moderate (≥ −3.00 D) to high (≥ −6.00 D). The prevalence of hypermetropia (≥ +2.00 D) in the better eye was 3.2 per cent (n = 16); 12 (2.4 per cent) being moderate (≥ +2.25 D) to high (≥ +5.25 D). The most common ocular conditions diagnosed at initial presentation were refractive error (n = 104, 20.1 per cent) and dry eyes (n = 57, 11.0 per cent). Conclusion Mild vision impairment and refractive error are significant issues for refugees attending the Australian College of Optometry, emphasising the need for optometry, particularly refractive, services in this population.

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Vision Impairment and Ocular Morbidity in a Refugee Population in Malawi

Cited by 14 publications

References 19 publications

Presbyopia: Effectiveness of correction strategies

Presbyopia: Effectiveness of correction strategies

Burden of eye disease and demand for care in the Bangladesh Rohingya displaced population and host community: A cohort study

Vision impairment and refractive errors in refugees presenting to community optometry clinics in Victoria, Australia

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